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EPI-EE is an investigational viscous oral formulation of the corticosteroid budesonide, specifically developed by the Hospital General de Tomelloso for the treatment of eosinophilic esophagitis (EoE). Budesonide is a potent synthetic glucocorticoid that acts as a glucocorticoid receptor agonist, exerting local anti-inflammatory effects that reduce eosinophilic infiltration in the esophageal mucosa. Standard delivery methods for budesonide, such as inhalers or standard oral tablets, are often ineffective for EoE due to rapid transit through the esophagus. The EPI-EE formulation is an extemporaneous preparation designed to increase viscosity, thereby extending the contact time of the active ingredient with the esophageal wall. This localized topical delivery allows for high concentrations of the drug at the site of inflammation while maintaining a favorable safety profile due to budesonide's high first-pass hepatic metabolism, which limits systemic corticosteroid exposure.
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